To assess the quality of life (QoL) of patients with an exudative Age-Related Macular Degeneration (AMD) treated by intravitreal Anti-VEGF (vascular endothelial growth factor) and determine its drivers in a real-life setting.

Methods

A self-reported survey was carried out among AMD patients belonging to 2 French associations. Only patients with exudative AMD and under active intravitreal anti-VEGF treatment over the last 6 months were included. Data on demographics, disease parameters, past and ongoing treatments were collected. One validated vision-specific QoL instrument was also considered: the NEI-VFQ-25. Patients were stratified into four groups of visual acuity (VA). A multivariate model was performed to identify the QoL drivers.

Results

Out of the 1,888 questionnaires mailed 32.4% were returned and 24.7% fulfilled the inclusions criteria and were fully completed for analyses. Patients’ mean age was 78.0 years (SD 7.6). 70.5% were women. 60.4% had bilateral disease. The mean duration of symptomatic exudative AMD was respectively of 7.2 (SD 5) and 2.3 years (SD 3) for the 1st and the 2nd eye. Most of anti-VEGF treated eyes (n=641) were treated for more than 1 year (77.4%). The mean annual number of anti-VEGF injections was 4.7 (SD 2.7). The mean NEI-VFQ-25 global score was 53.4 (SD 21.5). A decrease of this score was positively correlated to VA decrease (0.63;p<.0001). This correlation was observed for 11 subscales out of 12. The main risk factor associated to the lower Qol score was the worst VA category, with an odds ratio of 5.2 (CI95%[2.6-10.4];p<.0001).

Conclusions

In a real-life survey of patients treated and followed for exudative AMD, VA decrease was the strongest factor linked to QoL worsening. Other factors such as the number of Anti-VEGF injections were not correlated to QoL in this study. Then, preservation of useful VA still remains a major concern to improve patients’ QoL.